Search: onr:"swepub:oai:research.chalmers.se:3eb60393-5a20-4102-8ed8-dfa3be985d17" >
Plasma and Urine Fr...
Plasma and Urine Free Glycosaminoglycans as Monitoring Biomarkers in Nonmetastatic Renal Cell Carcinoma—A Prospective Cohort Study
-
- Gatto, Francesco, 1987 (author)
- Chalmers University of Technology
-
- Dabestani, Saeed (author)
- Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urologi,Urological cancer, Malmö,Lund University Research Groups,Urology,Central Hospital Kristianstad
-
- Bratulic, Sinisa, 1981 (author)
- Chalmers University of Technology
-
show more...
-
- Limeta, Angelo, 1996 (author)
- Chalmers University of Technology
-
- Maccari, F. (author)
- Universita Degli Studi Di Modena E Reggio Emilia,University of Modena and Reggio Emilia
-
- Galeotti, F. (author)
- Universita Degli Studi Di Modena E Reggio Emilia,University of Modena and Reggio Emilia
-
- Volpi, N. (author)
- Universita Degli Studi Di Modena E Reggio Emilia,University of Modena and Reggio Emilia
-
- Stierner, Ulrika, 1952 (author)
- Sahlgrenska universitetssjukhuset,Sahlgrenska University Hospital
-
- Nielsen, Jens B, 1962 (author)
- Chalmers University of Technology
-
- Lundstam, Sven, 1944 (author)
- Sahlgrenska universitetssjukhuset,Sahlgrenska University Hospital
-
show less...
-
(creator_code:org_t)
- Elsevier BV, 2022
- 2022
- English.
-
In: European Urology Open Science. - : Elsevier BV. - 2666-1683 .- 2666-1691. ; 42, s. 30-39
- Related links:
-
https://research.cha... (primary) (free)
-
show more...
-
http://dx.doi.org/10... (free)
-
https://doi.org/10.1...
-
https://research.cha...
-
https://lup.lub.lu.s...
-
http://kipublication...
-
show less...
Abstract
Subject headings
Close
- Background: No liquid biomarkers are approved in renal cell carcinoma (RCC), making early detection of recurrence in surgically treated nonmetastatic (M0) patients dependent on radiological imaging. Urine- and plasma free glycosaminoglycan profiles—or free GAGomes—are promising biomarkers reflective of RCC metabolism. Objective: To explore whether free GAGomes could detect M0 RCC recurrence noninvasively. Design, setting, and participants: Between June 2016 and February 2021, we enrolled a prospective consecutive series of patients elected for (1) partial or radical nephrectomy for clinical M0 RCC (cohort 1) or (2) first-line therapy following RCC metachronous metastatic recurrence (cohort 2) at Sahlgrenska University Hospital, Gothenburg, Sweden. The study population included M0 RCC patients with recurrent disease (RD) versus no evidence of disease (NED) in at least one follow-up visit. Plasma and urine free GAGomes—consisting of 40 chondroitin sulfate (CS), heparan sulfate, and hyaluronic acid (HA) features—were measured in a blinded central laboratory preoperatively and at each postoperative follow-up visit until recurrence or end of follow-up in cohort 1, or before treatment start in cohort 2. Outcome measurements and statistical analysis: We used Bayesian logistic regression to correlate GAGome features with RD versus NED and with various histopathological variables. We developed three recurrence scores (plasma, urine, and combined) proportional to the predicted probability of RD. We internally validated the area under the curve (AUC) using bootstrap resampling. We performed a decision curve analysis to select a cutoff and report the corresponding net benefit, sensitivity, and specificity of each score. We used univariable analyses to correlate each preoperative score with recurrence-free survival (RFS). Results and limitations: Of 127 enrolled patients in total, 62 M0 RCC patients were in the study population (median age: 63 year, 35% female, and 82% clear cell). The median follow-up time was 3 months, totaling 72 postoperative visits —17 RD and 55 NED cases. RD was compatible with alterations in 14 (52%) of the detectable GAGome features, mostly free CS. Eleven (79%) of these correlated with at least one histopathological variable. We developed a plasma, a urine, and a combined free CS RCC recurrence score to diagnose RD versus NED with AUCs 0.91, 0.93, and 0.94, respectively. At a cutoff equivalent to ≥30% predicted probability of RD, the sensitivity and specificity were, respectively, 69% and 84% in plasma, 81% and 80% in urine, and 80% and 82% when combined, and the net benefit was equivalent to finding an extra ten, 13, and 12 cases of RD per hundred patients without any unnecessary imaging for plasma, urine, and combined, respectively. The combined score was prognostic of RFS in univariable analysis (hazard ratio = 1.90, p = 0.02). Limitations include a lack of external validation. Conclusions: Free CS scores detected postsurgical recurrence noninvasively in M0 RCC with substantial net benefit. External validity is required before wider clinical implementation. Patient summary: In this study, we examined a new noninvasive blood and urine test to detect whether renal cell carcinoma recurred after surgery.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- Liquid biopsy
- Glycosaminoglycans
- Renal cell carcinoma
- Tumor biomarkers
- Glycosaminoglycans
- Liquid biopsy
- Renal cell carcinoma
- Tumor biomarkers
Publication and Content Type
- art (subject category)
- ref (subject category)
Find in a library
To the university's database
- By the author/editor
-
Gatto, Francesco ...
-
Dabestani, Saeed
-
Bratulic, Sinisa ...
-
Limeta, Angelo, ...
-
Maccari, F.
-
Galeotti, F.
-
show more...
-
Volpi, N.
-
Stierner, Ulrika ...
-
Nielsen, Jens B, ...
-
Lundstam, Sven, ...
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Surgery
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Urology and Neph ...
- Articles in the publication
-
European Urology ...
- By the university
-
Chalmers University of Technology
-
Lund University
-
Karolinska Institutet